Sitting in a metro, it would probably be difficult to imagine the anguish caused by lack of access to a specialist doctor at times of medical emergency.

Today in India, like it or not, specialist consultants in the medical field prefer practicing in the capital cities if not only the four major metropolitan cities.

That leaves close to 75 per cent of India 1.1 billion populace living in rural and semi-urban areas outside the reach of secondary and tertiary medical support.

The answer lies in an emerging and life saving idea called telemedicine services.

Simply put, telemedicine is an amalgam of telecommunication, computers and medicine. Experts opine that with the help of telemedicine a specialist's help can be reached at one sixth to one tenth the cost getting it at a metropolitan cities.

The best part of course is that this service can be availed without moving out one's hometown.

Chennai-based Apollo Hospitals has already taken a lead role in the proliferation of telemedicine centers in the remotest parts of the country.

At a modest investment of Rs 550,000, a telemedicine centre can be set up in part of the country. For this money, you would get P4 computer, a 29-inch color monitor, a scanner and video camera. Connect to the Internet using a ISDN line and you have the choicest of specialist doctors only a call away.

Prof K Ganapathay, senior consulting neurosurgeon and medical director with Apollo Telemedicine Networking Foundation, says, "There are 750 neurosurgeons in India all of whom are located at the state capitals. Around 68 of these are in Chennai alone.

In fact, Apollo has more neurosurgeons than the entire state of Assam. This anomaly is prevalent not just in neuro, but in the entire gamut of specialists fields. This means 75 per cent of India's population who live in the rural and sub-urban regions do not have access to medical specialists."

The solution to the 'demand-supply' mismatch is addressed through the help of telemedicine center, which delivers the last mile service through a local doctor.

"In my own experience, 8 out of 10 cases do not even need the help of a specialist neurosurgeon like me. I take one look at the patient and can say his headache is not due to a brain tumor and could be just his mother-in-law," Prof Ganapathy quips.

"Apollo has tied up with Anna University to provide telemedicine through the 240 engineering colleges in Tamil Nadu and to reach out to the length and breadth of the state. This model will be replicated to other states in the future," says Arnap Sen, vice president, Apollo Health Street Ltd.

Telemedicine does not come as a relief not to the patients in the remote corners of the country but also to the government. Prof. Ganapathy drives home the point with some of the findings of National Council for Applied Economic Research.

"According to a NCAER study, we need to invest Rs 25,000 crore (Rs 250 billion) every year to build 750 hospitals of 250-bed capacity each to meet the basic medical support recommended by the World Health Organisation. This is simply not going to happen. The answer to his mammoth task lies in telemedicine," Ganapathy says.

"A graduate can do it. Apollo has tied up with Anna University to train science graduates to man the telemedicine centers. To start with we would like to train 100 graduates every year. This is a three week intensive programme and the students passing out this course can be fanned out across the country to man our telemedicine centres," he says.

Apollo has also managed to even commission 14 telemedicine centers for the India army's Southern and Central Command.

According to Sen, the future of telemedicine business potential looks bright.

He says, "Expansion is happening at three fronts. One, wider reach - from rural (domestic) to international, two increasing level of sophistication and greater usage, with bandwidth availability increasing and options such as VSAT now becoming easier and ISDN/ leased line connectivity also increasing.

Third, greater specialisation like tele-cardiology, tele-radiology etc depending on the specific stream of medical field involved.

Diagnostics and consultation is only the first step to the new age medical support. It would not be too far for India to touch the frontiers of high-tech medical support through tele-surgery.

"Tele-surgery is emerging in the west. We are not yet ready for it in India. In fact, for us, it is not on the radar at the moment," says Prof Ganapathy.

The country might not be ready for tele-surgery, but it would neither be just a pipe dream to expect a specialist in Chennai perform a tele-surgery to a patient in the remotest corner of the North-East. It is just a question of time.